1. Technical Field
The present disclosure relates to systems and methods for providing automated detection of spinal curvature and, more particularly, to systems and methods for providing automated detection of spinal curvature using images of the spine and angle measurements.
2. Discussion of Related Art
The spine is made up of twenty-four vertebrae which are separated by discs. The normal curves of the spine provide the spine with the properties of flexibility, resiliency and shock absorbency. Scoliosis is a musculoskeletal condition in which there is an abnormal lateral curvature of the spine, causing the spinal column to bend to the left or right. Various studies have defined scoliosis as a lateral deviation of the normal vertical line of the spine which, when measured by X-rays, is greater than ten degrees. Whereas a normal spine, when the body is viewed from directly behind, has the appearance of a straight line, a spine with scoliosis resembles the letter S or C, because of the abnormal curvature. Scoliosis starts when the spine does not develop its normal front to back arches, which causes unusual weight to be carried on the discs. The center of certain discs shifts to one side and the vertebra tip to the other. This misalignment, called a subluxation, causes the spine to bend to the left or right. To compensate for this bend, the spine tips to the other side at another level and the result is scoliosis.
Scoliosis can occur at any age, but most often appears in early adolescence. Screening is useful when early identification enables treatment to be started that may halt the progression of the deformity. The Scoliosis Research Society and the American Academy of Orthopaedic Surgeons have endorsed school screening programs to detect scoliosis curves before they may become advanced. To diagnose the condition, a doctor may request an X-ray to get a better view of the spine. In an X-ray image, the curve of the scoliosis is usually measured by looking at the back view of the spine and measuring the angle formed by the top and bottom vertebrae of the curve. This measurement is called the Cobb angle.
Kyphosis is a spinal deformity which can be seen in association with scoliosis. Kyphosis in the thoracic spine means exaggerated kyphotic angle from the spine's normal kyphotic curve. A spine affected by kyphosis shows evidence of a forward curvature of the vertebrae in the upper back area, which leads to a “humpback” appearance. The Scoliosis Research Society defines kyphosis as a curvature of the spine measuring forty-five degrees or greater on an X-ray. The normal spine has only about twenty to forty-five degrees of curvature in the upper back area. Kyphosis is indicated in lateral X-ray images of the spine by the kyphotic angle, which is the superior angle formed by intersection of two lines drawn on a lateral chest radiogram, tangential to the anterior borders of the second and eleventh intervertebral disc spaces.
Using current methods, the Cobb angle is calculated by hand. FIG. 1 illustrates the hand calculation of the Cobb angle in a coronal view of the spine. Referring to FIG. 1, the first step is to find the end-vertebrae which are the vertebrae at the upper and lower limits of the curve which tilt most severely toward the concavity of the curve. Once these vertebrae have been selected, a line is drawn along the upper endplate of the upper body and along the lower endplate of the lower body as shown in FIG. 1. The kyphotic angle is also determined by hand. It is defined in the same way as the Cobb angle but is calculated from lateral images. The quality of an image of the spine may be poor, making it difficult if not impossible to locate the limits of the vertebrae, such as when the image is an X-ray image of the spine.